title: Prevalence and aetiology of anaemia in lymphoid malignancies.
abstract: BACKGROUND
  We prospectively studied the prevalence, type and causes of anaemia in newly diagnosed patients with lymphoid malignancies.
  
  
  METHODS
  Between January 2007 and June 2008, a total of 316 newly diagnosed, consecutive patients (aged 15 years or above) of Hodgkin lymphoma, non-Hodgkin lymphoma and chronic lymphocytic leukaemia with anaemia (haemoglobin <11 g/dl), were analysed to determine the prevalence and a subgroup of 46 patients was analysed for the cause of anaemia.
  
  
  RESULTS
  Hodgkin lymphoma, non-Hodgkin lymphoma and chronic lymphocytic leukaemia were the diagnoses in 81 (25.8%), 203 (64.7%) and 30 (9.6%) patients, respectively. Anaemia was present in 134 patients (42.4%). Anaemia of chronic disease was present in 33/46 (71.7%) and iron deficiency in 18/46 (39.1%) patients. Vitamin B12 and/or folate deficiency was detected in 10/46 (21.7%) patients (B12 deficiency alone in 7, folate deficiency alone in 1 and combined B12 and folate deficiency in 2). Autoimmune haemolytic anaemia was detected in 5/46 (10.9%) although direct Coombs test was positive in 17/46 (37%) patients. Among patients with Hodgkin lymphoma and non-Hodgkin lymphoma, anaemia due to bone marrow involvement was present in 16/40 (40%). In most patients with bone marrow involvement, anaemia was due to other causes. In only 3 patients, anaemia was attributable to bone marrow involvement alone. Anaemia was multifactorial in 18/46 (39.1%) patients. Nutritional deficiency alone or in combination was present in 22/46 (47.8%) patients.
  
  
  CONCLUSIONS
  Anaemia is common in lymphoid malignancies at initial presentation. Besides managing anaemia of chronic disease and bone marrow involvement, nutritional and autoimmune causes should be ruled out.
authors.affiliation: Tata Memorial Hospital, Parel, Mumbai 400012, Maharashtra, India - Department of Medical Oncology.
authors.forename: J
authors.initials: J
authors.lastname: Ghosh
authors.forename: R K Bikramjit
authors.initials: RK
authors.lastname: Singh
authors.forename: R
authors.initials: R
authors.lastname: Saxena
authors.forename: R
authors.initials: R
authors.lastname: Gupta
authors.forename: S
authors.initials: S
authors.lastname: Vivekanandan
authors.forename: V
authors.initials: V
authors.lastname: Sreenivas
authors.forename: V
authors.initials: V
authors.lastname: Raina
authors.forename: A
authors.initials: A
authors.lastname: Sharma
authors.forename: L
authors.initials: L
authors.lastname: Kumar
mesh_terms: D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000453:epidemiology* / Q000209:etiology*; D000744:Anemia, Hemolytic, Autoimmune / Q000453:epidemiology / Q000209:etiology; D018798:Anemia, Iron-Deficiency / Q000453:epidemiology / Q000209:etiology; D001853:Bone Marrow / Q000473:pathology; D005260:Female; D005494:Folic Acid Deficiency / Q000150:complications; D006689:Hodgkin Disease / Q000150:complications*; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications*; D008228:Lymphoma, Non-Hodgkin / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D014806:Vitamin B 12 Deficiency / Q000150:complications; D055815:Young Adult